AROUSAL AND ATTENTION IN HIGH-RISK NEONATES

该项目继续研究早产儿和脑损伤新生儿， 假设(A)这些风险条件不同地降低了 调节唤醒和注意过程的能力，以及(B) 唤醒/注意调制的干扰模式预测两者 早期脑损伤程度和晚期认知和 激励性发展。我们已经制定和完善了一项措施 使用视觉偏好技术的新生儿行为显示 受控偏好函数的系统差异 由于内部和外部的变化而引起的唤醒操作 刺激的来源。我们已经证明：(A)高风险和 与正常足月儿相比，早产儿表现出普遍的 通过唤醒操作看起来更偏爱；但(B)更 脑损伤越严重，注意力转向越少 较少唤醒时的频率较高。本提案将使 美国将确定中枢神经系统病理如何通过低唤醒/注意力发挥作用 调制在新生儿身上，可以形成日后行为的底物 发展并能在不同的情况下表达与更高的- 认知水平。婴儿(n=288)分为8组 与脑损伤相关的研究将从出生到19个月的3岁 月份间隔。我们设计的研究将提供汇聚 来自唤醒调制视觉识别记忆的测量的信息， 皮质醇对不同应激源的反应性和迷走神经调节的控制 心率过快。我们预测，唤醒操作将会调节 不同措施的响应，但响应调制的程度将 受中枢神经系统损害程度和类型的不同影响。之前 到出院，在1个月和4个月时，视觉识别记忆 会以一种类似于视觉的方式与唤醒水平互动 偏好任务使得偏好之间的差异的大小 因为不同唤醒条件下的新颖性将与中枢神经系统成正比 年龄越大、身体越健康的婴儿，性唤起的影响就越小。 随着婴儿的成熟，将需要更具挑战性的任务来 区分脑损伤；例如，涉及感觉间的损伤 (听觉-视觉)整合可能成为更好的鉴别器。我们 假设测量注意力集中，注意力分散， 易怒、目标导向型行为和以后的探索性行为 年龄与早期注意力缺乏调节有关。

This project continues to study premature and brain injured neonates, hypothesizing (a) that these risk conditions differentially reduce the ability to modulate arousal and attention processes, and (b) that the pattern of disruption in arousal/attention modulation predicts both degree of early brain injury and later percentual cognitive and motivational development. We have developed and refined a measure of neonatal behavior using the visual preference technique that shows systematic differences in preference functions with controlled manipulations of arousal due to changes in internal as well as external sources of stimulation. We have demonstrated that: (a) high-risk and preterm infants, as to normal term infants, show a general shift in looking preference with arousal manipulations; but that (b) the more severe the brain injury, the less the shift in looking preferences toward higher frequencies when less aroused. The present proposal will enable us to establish how CNS pathology, acting through poor arousal/attention modulation in the neonate, can form the substrate on which later behavior develops and can be expressed in diverse circumstances related to higher- level cognitive attainment. Infants (n=288) stratified into 8 groups related to brain injury will be studied from birth to 19 months at 3 month intervals. We have designed studies that will provide converging information from measures of arousal modulated visual recognition memory, cortisol reactivity to different stressors, and vagally mediated control over heart rate. We predict that arousal manipulations will modulate responding across measures, but that degree of response modulation will be differentially affected by degree and type of CNS compromise. Prior to hospital discharge, and at 1 and 4 months, visual recognition memory will interact with arousal level in a manner analogous to the visual preference task such that the magnitude of difference between preferences for novelty in different arousal conditions will be proportional to CNS insult, with arousal less influential the older and healthier the infant. As the infant matures, more challenging tasks will be needed to differentiate brain injury; for example, those involving intersensory (auditory-visual) integration may become better discriminators. We hypothesize that measures of focused attention, distractibility, irritability, goal-directed behavior, and exploratory behavior at later ages will correlate to lack of modulation of early attention.